Trade, foreign policy, diplomacy and health

8. International Health Regulations and Epidemic Control

Johan Giesecke

Epidemic control as a public good

  • National regulatory measures constitute clear public goods for health e.g. clean water
  • National infection control has two parts covered by legislation:
    • identification of a health problem
    • actions to control it
  • Although clear responsibilities on national level, generally lacking internationally

Nationally, most regulatory measures applied by a state to protect its citizens from infection constitute clear public goods for health. Eg providing clean water and sanitation will confer a good that is both non-excludable (it will benefit everyone, even those totally unaware of the risks eliminated), and non-rivalrous (my benefit will not preclude my neighbour's).

National infection control has two parts: the identification of a health problem, and the actions taken to control it. Most countries have legislation covering both parts: the continuing surveillance of infectious diseases, and the appointed agencies to deal with problems observed. In many developed countries those mechanisms have now been progressively refined and extended to the point at which surveillance is more aimed at detecting the occasional breakdown in routine control procedures than at the discovery of completely new problems.

What should be clear is that responsibilities for surveillance and for control are clearly defined and delineated by legislation. Physicians are obliged to notify certain infectious diseases, and failure to do so may have repercussions. Water companies are under strict regulations for how, and how often, the purity of their water should be checked. In addition to such public health laws, there is an increasing tendency for individuals or groups to take legal action against a company whose products may have spread disease, and such disputes can also be handled by national legislation. Such 'enabling' goods are generally lacking on the international level.